Kouzegaran Samaneh, Zamani Mohammad Ali, Faridhosseini Reza, Rafatpanah Houshang, Rezaee Abdolrahim, Yousefzadeh Hadis, Movahed Rahman, Azad Farahzad Jabbari, Tehrani Hooman
Allergy Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Pediatric Department, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Open Access Maced J Med Sci. 2018 Jul 16;6(7):1248-1252. doi: 10.3889/oamjms.2018.264. eCollection 2018 Jul 20.
Allergic rhinitis is one of the most common allergic diseases and characterised by sneezing, rhinorrhea, nasal congestion and nasopharyngeal itching. Subcutaneous immunotherapy (SCIT) for specific allergens is an effective treatment and induces the inhibitory effect of T regulatory lymphocytes and decreases clinical symptoms in allergic rhinitis.
In this study effect of subcutaneous immunotherapy with specific allergens on clinical symptoms and T regulatory and T Helper cells cytokines, in patients with allergic rhinitis are evaluated.
In this study, 30 patients with moderate to severe allergic rhinitis according to clinical criteria and positive skin prick test for aeroallergens were selected and treated by SCIT. Clinical symptoms and T cells cytokines IL4, IL17, IFN gamma, TGF beta, GITR, FOXP3 and IL-10 (by RT-PCR) were evaluated before and one year after initiation of treatment.
Thirty (30) patients with allergic rhinitis at age range 15-45 years old were treated by SCIT, and 23 (14 female, 9 male) patients continued the study, and 7 patients did not continue treatment. After immunotherapy, clinical symptoms decreased significantly. The specific cytokines TGF beta and IL10 levels increased and changes were statistically significant. (Respectively P = 0.013 and P = 0.05) The IL17 level was also increased, but not statistically significant. (P = 0.8) IFN gamma, IL4, GITR, FOXP3, all decreased, but the changes were not statistically significant (P > 0.05).
Subcutaneous Immunotherapy for specific allergens decreases clinical symptoms in patients with allergic rhinitis and induces tolerance in T lymphocytes, especially by increasing T regulatory cells cytokines, TGF beta and IL10.
过敏性鼻炎是最常见的过敏性疾病之一，其特征为打喷嚏、流涕、鼻塞和鼻咽部瘙痒。针对特定过敏原的皮下免疫疗法（SCIT）是一种有效的治疗方法，可诱导调节性T淋巴细胞产生抑制作用，并减轻过敏性鼻炎的临床症状。
本研究评估针对特定过敏原的皮下免疫疗法对过敏性鼻炎患者临床症状以及调节性T细胞和辅助性T细胞细胞因子的影响。
本研究选取了30例根据临床标准诊断为中重度过敏性鼻炎且对空气过敏原皮肤点刺试验呈阳性的患者，并采用皮下免疫疗法进行治疗。在治疗开始前及治疗1年后评估临床症状以及T细胞细胞因子白细胞介素4（IL4）、白细胞介素17（IL17）、干扰素γ（IFNγ）、转化生长因子β（TGFβ）、糖皮质激素诱导的肿瘤坏死因子受体（GITR）、叉头框蛋白3（FOXP3）和白细胞介素10（通过逆转录聚合酶链反应）。
30例年龄在15至45岁的过敏性鼻炎患者接受了皮下免疫疗法治疗，23例（14例女性，9例男性）患者继续参与研究，7例患者未继续治疗。免疫治疗后，临床症状显著减轻。特定细胞因子TGFβ和IL10水平升高，且变化具有统计学意义（分别为P = 0.013和P = 0.05）。IL17水平也有所升高，但无统计学意义（P = 0.8）。IFNγ、IL4、GITR、FOXP3均下降，但变化无统计学意义（P > 0.05）。
针对特定过敏原的皮下免疫疗法可减轻过敏性鼻炎患者的临床症状，并诱导T淋巴细胞产生耐受性，尤其是通过增加调节性T细胞细胞因子TGFβ和IL10来实现。
